"You're just stressed," says a person who does not deal with anxiety. "No, my thoughts and feelings are spiralling out of control, I can't breathe, there's a sinking feeling in my stomach that has been there for days, I can't sleep, I am convinced I'm dying at least 10 times a day. And I forgot to turn off my hair straighteners, probably." As a person who has dealt with serious anxiety issues [1], nothing bothers me more than someone deducing what I'm going through into your average bout of low-key stress.

For me, stress is when I have a lot on my plate and am worried about getting it all done in time. Anxiety is the paralysing notion [2] that nothing I ever do will be enough, and there's no tangible way to even begin to fix it. Pretty different, right? Well, Dr. Alison Darcy, a clinical psychologist and CEO of Woebot [3], explained how the stress and anxiety are connected and how aspects of both aren't as different as you'd think. So, how do you differentiate stress from anxiety? And are they interchangeable? While the two are undeniably very different issues, they can, in some cases, be addressed and helped in similar ways.

What is the difference between stress and anxiety?

"Stress is when the perception of what you need to do is going beyond your perceived capability to get it done. A useful distinction is 'healthy worry' vs. anxiety. Worry is something that's reasonably healthy, it's adaptive, it makes sure our Ts are crossed and Is are dotted when we're worrying about things, and helps us be conscientious," said Darcy.

It becomes maladaptive anxiety when these worries are keeping us up at night, when it's something that we can't easily shake.

"Then you're thinking catastrophes, and you're thinking worst-case scenarios," said Darcy, "when actually if you could dial it down to an 'adaptive level,' you'd be like, 'Oh, I want to make sure I do a good job of this presentation tomorrow.' And it becomes much more behaviourally adaptive. 'Oh, I'll just prepare' rather than worrying about making a complete fool of yourself with this presentation."

This type of anxiety is different from regular stress, so Darcy suggests the way to "dial it down" is to write down all of the things you're thinking and look at those thoughts to see if they are distorted.

So are anxiety and stress interchangeable?

Well, that depends. Because there are different types of anxiety and manifestations of the mental illness, it certainly isn't the same thing as stress, therefore they are not interchangeable in that sense. However, in some cases, Darcy said that the way we address anxiety and chronic stress can be interchangeable.

From a clinician's point of view, she thinks about stress as being a more physiological state, and particularly chronic stress would be referred to in the medical and professional in terms of the physiological effects of long-term exposure to cortisol. A stressful state and an anxious state are quite similar because anxiety has this physiological side as well as a psychological side. She even went as far as to say that in some ways, stress and anxiety are interchangeable in how they work inside of you and that they can be treated in similar ways.

"It would be this process of identifying what's the situation in which that exemplifies what you're feeling. Let's think about how you're feeling and what does that stress look like to you? Some people feel it very mentally, like 'I'm having all these racing thoughts of concern and anxiety,' and other people feel both stress and anxiety physiologically — 'I can't breathe, my palms are sweating.' And so I think you'd want to differentiate between those two states and then break down what is the thinking behind it. What are you telling yourself that's causing you to have this stress response or this anxious response? And let's really test that against the reality of the situation. We're all walking around with these distorted thoughts that we take as 100 percent true. We believe that's the truth because we're not used to getting outside of ourselves."

Cognitive behavioural therapy involves "homework" that requires patients to write down those distorted thoughts so that they get them out and hopefully can look at them more objectively in order to address the stress or anxiety they are causing someone. This form of therapy helps those dealing with both stress and/or anxiety, despite the fact that they are two different things entirely.

Stress, then, is something that is more easily redirected into something positive and actionable, whereas anxiety can (and does) have physiological and psychological effects that differ and are often maladaptive. Still, the key for both is to recognise the distorted thoughts and feelings in an effort to "dial them back" and address them in order to either overcome them or transform them into something positive and even beneficial.